Attitudes To Change: Cynicism Is Not a Substitute for Prudent Patient Care

Rory Fleming Richardson, Ph.D., ABMP

In today’s world of elevated concern about pain medication addiction, it is all to common for physicians to react to a patient’s complaints of pain by thinking that this may only be drug-seeking behavior. Although this is a concern, there are more pressing issues that may be overlooked if a premature assumption is made in regard to drug seeking behavior. Unfortunately, some physicians are all too ready to label a patient rather than to address the fact that pain is simply a signal that there is something physically wrong. When a physician infers that a patient is simply drug-seeking, they will alienate the patient and risk missing the more important questions which make the difference between negligence and proper medical practice. Here are some of the questions that the physician and quality assurance reviewers need to ask in order to assure that the patient obtains proper care and follow-up:

• What tests were run when the patient came in?

• Was the patient examined?

• How much history was taken and was onset/course identified?

• What is the follow-up plan?

• What is the etiology of the patient’s reports?

• Before assuming there is any drug seeking, was there adequate determination if there is not a reason for overt, acute pain?

• If there has been any recent (within the last three months) surgical procedure, has the surgical report been reviewed for complications?

• What post-operative instructions (written and oral) was the patient given?

• Did the patient follow post-operative instructions?

• Was the patient and/or family provided information on what to expect post-op?

• If the current symptoms are outside of those expected, what are the reasons, and what testings were completed to rule out complications?

The beginning of quality care is listening to the patient. If lab tests are needed to rule out problems, they should be run before drawing any conclusions.

The rule of thumb is simple: Treat the patient with the same respect and attention you would wish for yourself.